Conference taveng::bagels

583.0. "Travel advisory to Israel." by HPSTEK::AMIR () Mon Nov 14 1988 10:34

From:	NAME: Richard Porter @CFO           
	FUNC: CORP. HEALTH SERVICES   
	TEL: 251-1314             <PORTER.RICHARD AT A1 AT BARTLE AT CFO>
Date:	10-Nov-1988
Posted-date: 10-Nov-1988
Precedence: 1
Subject: TRAVEL ADVISORY: ISRAEL

To:	See Below





I am attaching for your information a recent CDC Travel Advisory
regarding an outbreak of poliomyelitis in Israel and request that you
inform any of your employees who may be traveling to Israel.  

The U.S. Public Health Department recommends "that travelers to
countries where poliomyelitis is occurring -- which now temporarily
includes Israel -- be immunized."  This is particularly important for
persons who have not been immunized or whose immunization was
incomplete, but a 'booster' is also recommended for the majority of
U.S. residents who have previously completed the basic immunization. 

I have already distributed this information to Digital Health Services 
Departments in North America and Europe, so that your site Digital 
Nurse should be able to answer employee questions and, at some sites, 
provide the necessary immunization.





Author:	Richard Porter @CFO           
Date:	10-Nov-1988
Posted-date: 10-Nov-1988
Precedence: 1







             U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
			PUBLIC HEALTH SERVICE
		     CENTERS FOR DISEASE CONTROL
			ATLANTA, GEORGIA 30333


ADVISORY MEMORANDUM NO.95                          October 14, 1988

SUBJECT:  Poliomyelitis - Israel

Between July 31 and September 28, 1988, 16 persons in Israel were 
reported with onset of confirmed or suspected paralytic poliomyelitis. 
Thirteen cases were reported from the Subdistrict of Hadera located 
approximately 30 miles northeast of Tel Aviv.  To date, Type I 
poliovirus has been isolated from eight persons.  Vaccination of all 
persons through age 39 years was carried out in Hadera and is in 
progress in the other 14 subdistricts.  Epidemiologic investigation is 
continuing.  

Proof of poliomyelitis immunization is not required for international 
travel.  However, the Immunization Practices Advisory Committee (ACIP) 
recommends that travelers to countries where poliomyelitis is 
occurring - which now temporarily includes Israel - be immunized.  
Schedules for primary immunization against poliomyelitis require three 
or more doses.  In general, oral poliovirus (OPV) is the vaccine of 
choice for persons younger than 18 years of age.  Unimmunized adults 
(18 years or older) should receive at least two doses of enhanced 
potency inactivated poliovirus vaccine (eIPV), at least 4 weeks apart, 
and preferably a complete primary series, before traveling.






If an individual's travel plans do not permit this interval, then a single 
dose of OPV or eIPV is recommended.  For adults incompletely immunized 
with OPV or IPV, the remaining doses should be given to complete the 
primary series, regardless of the interval since the last dose or the 
type of vaccine previously received; either OPV or eIPV can be used to 
complete the series.  A single additional dose of either OPV or eIPV 
should be given to travelers of all ages who completed a primary 
series of OPV or IPV.  ACIP recommendations on poliomyelitis 
prevention should be consulted for further details.

Walter A. Orenstein, M.D.            Charles R. McCance
Director                             Director
Division of Immunization             Division of Quarantine
Center for Prevention Services       Center for Prevention Services

                                

>                                                   Vaccination of all 
> persons through age 39 years was carried out in Hadera and is in 
> progress in the other 14 subdistricts.

Following the recommendations of an international commission of doctors,
the entire population of Israel and the territories, up to the age of 40,
was given the oral vaccine.  For anyone who's interested, this involves
opening your mouth while a nurse squeezes 2 drops from a small plastic bottle
onto your tongue.  The government covered the cost of the program, the vaccine
being given without charge.  Those over 40 were excluded because older people
are less susceptible to polio; they were allowed to get the vaccine, of
course, but were supposed to pay for it.

    In the Boston area call Logan airport's international travel clinic
    at 617-569-8652.  They are presently out of the vaccine, but are
    expecting more next week.

    Not to get too far into "MEDICAL notes" territory:

    When I tried to get the vaccine I was told that there is an increased
    chance of side effects from the oral vaccine for persons over 18.

    
    You can also get the vaccine at the Mount Auburn Hospital Travel
    Clinic, a good place to know about if you do a lot of overseas
    traveling.
    
    They, by the way, are strongly recommending the vaccine rather than the
    oral.